Botox

Lower face

A closer look at your muscles

Ultrasound-guided Botox in Hale, Altrincham

For a less bulky jaw or a muscle that still bulges after Botox, ultrasound helps Dr Alex see what to target and guide the treatment.

Perhaps one side of your jaw looks stronger than the other, or a muscle still bulges when you clench despite previous Botox. You'd like to know what's going on before having more.

Ultrasound puts a live image of the muscle on screen. Dr Alex can assess its shape, depth and movement, then use that information to help target treatment. It's particularly useful in selected masseter treatments - the strong chewing muscles at the sides of your jaw.

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Dr Alex has contributed to Aesthetics Journal's coverage of ultrasound in aesthetic medicine.

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Guidance
Live ultrasound imaging
Recovery
Usually little downtime
Results
Develop gradually
Treatment costs
Confirmed at consultation

What you've noticed

When a closer look could help

You don't need to know the name of the muscle. Start with what you can see or feel.

One side looks stronger

Your jaw looks broader on one side, especially when you bite together. You want to understand whether the difference comes from muscle before trying to change it.

A bulge appears when you clench

Part of your jaw muscle pops out when you bite, perhaps after an earlier treatment. A scan can help show which part is still contracting.

You want a more targeted plan

You've been told Botox might help, but you're unsure where it would go or what it would change. Seeing the muscle can make the explanation much easier to follow.

At a glance

The scan and the treatment

Ultrasound adds information to your assessment. The injections produce the muscle-relaxing effect.

Guidance
Live ultrasound imaging
A probe on the skin shows the muscle and surrounding tissues on screen.
Recovery
Usually little downtime
Small injection marks, tenderness or bruising can occur; the scan itself needs no recovery.
Results
Develop gradually
Muscle relaxation appears before a visible reduction in muscle bulk, which takes longer.
Treatment costs
Confirmed at consultation
Your quote will explain the treatment area and ultrasound arrangements before you proceed.
Duration
Temporary muscle relaxation
Further treatment may be considered as activity returns, according to your response and goals.

The result

Target the muscle behind the concern

When a large masseter is making the lower face look wide, relaxing it can gradually soften that square-jaw appearance.

Ultrasound helps Dr Alex distinguish the muscle's layers and see how they move. This can be useful when the anatomy is less straightforward or a previous treatment has left a patch that still bulges.

The change you see depends on the muscle being treated, the dose and how your face is built. Imaging helps with targeting; it doesn't replace the judgement about whether reducing that muscle will look good on you.

✓

✓

Reduce suitable jaw-muscle bulk for a less square lower-face outline.

✓

Assess differences between the muscles on each side before choosing the treatment plan.

✓

Identify a contracting area that may explain a persistent bulge after previous treatment.

✓

Understand what is being treated, with the scan helping Dr Alex explain the decision.

Is it right for you?

When does the scan help?

A scan is most useful when it can answer a question that affects your treatment.

The concern appears muscle-related
A muscle becomes prominent when you clench or move, and you want to reduce its activity or bulk. Dr Alex will check that the proposed change suits the rest of your face.
The previous response needs explaining
One area responded differently, or an unexpected bulge appeared. Bring the date, product and dose if you have them, along with photographs showing the change.
The target needs closer assessment
The muscle's depth, boundaries or movement would benefit from a clearer view. Dr Alex can explain what the scan adds in your particular case.

Choosing the right treatment

A wider jaw isn't always a bigger muscle

Bone shape, fat and skin all affect your jawline. Reducing an already small muscle can make hollowing or jowls more noticeable. Assessment comes before any decision to inject.

How it works

See the muscle while planning the injection

Ultrasound uses sound waves to create an image beneath the skin. There is no radiation.

A small probe moves over gel on your skin. Dr Alex may ask you to clench or relax so he can see the target muscle working. The image helps show its boundaries and nearby structures.

Scanning can be used to map the area beforehand and to guide placement during an injection. Botulinum toxin then reduces the nerve signal telling the treated muscle to contract. The ultrasound is the guide; the medicine does the treatment.

Your appointment

From your concern to a treatment plan

Tell Dr Alex what you'd like to change and what happened with any previous treatment.

Consultation

Discuss the result you want

Dr Alex examines your face at rest and in movement, reviews your medical history and asks about earlier injections. If you're seeking help with clenching or pain, the cause also needs assessment.
Ultrasound assessment

Look beneath the skin

Gel and the probe are placed over the relevant area. Dr Alex explains what he can see and whether it changes the recommended treatment.
If treatment is suitable

Treat the agreed muscle

The injections follow the agreed plan, with ultrasound guidance where needed. You'll feel the needle pricks; the scan is usually comfortable.
Afterwards

Allow the result to develop

You'll receive aftercare and a plan for review. If the aim is jaw slimming, give the muscle time to reduce in size rather than judging the result after a few days.

Why Dr Alex

Why choose Dr Alex for ultrasound-guided Botox?

Dr Alex contributed to Aesthetics Journal's feature on using ultrasound in aesthetics and teaches other clinicians in aesthetic medicine. His interest is in how imaging can help answer a real treatment question.

For you, that means looking at the muscle, your previous response and the shape you'd like to achieve together. He can explain when scanning is useful, when a routine assessment is enough, and when Botox is unlikely to improve the concern.

GMC-registered doctor · 7072776

Full Member of BCAM

International toxin trainer

Aesthetics Awards winner 2021

Safety and aftercare

What to expect after the injections

Small bruises, tenderness and short-lived swelling at the injection points can happen. Most people can return to ordinary daily activities.

Possible side effects

Risks depend on the area treated. With masseter treatment, temporary chewing weakness, an uneven smile or a muscle bulge can occur. Reducing muscle bulk may also reveal hollowing or looser skin. Ultrasound does not remove these risks.

Dr Alex will discuss the risks relevant to your plan and give you aftercare and contact details.

When to get urgent help

Seek immediate medical help for difficulty swallowing, speaking or breathing, or new widespread muscle weakness after treatment. Call 999 for breathing difficulty or signs of a severe allergic reaction. Contact the clinic promptly about an unexpected change in your smile or worsening local symptoms.

When treatment may not be suitable

Treatment is usually deferred during pregnancy or breastfeeding, or if the injection area is infected. Tell Dr Alex about muscle or nerve conditions, swallowing problems, allergies, medicines and any recent botulinum toxin treatment elsewhere.

You can ask questions, change your mind or leave the consultation without having treatment.

Treatment costs

A quote for your treatment plan

The cost of ultrasound-guided Botox is confirmed at consultation, based on the area and the assessment and treatment needed.

Ultrasound-guided Botox
Agreed at consultationfor your agreed treatment plan
The scan, treatment and review arrangements are agreed before you decide, including any separate scanning charge. Standard injection fees are not quoted as all-inclusive ultrasound-guided prices.
A consultation with Dr Alex costs £75. If you choose to have treatment within 3 months of your consultation, you can put this fee towards it, including at a later appointment. It cannot be used towards skincare products. If you decide not to have treatment, the fee covers your consultation.
Book a consultation
We'll explain the scan, injection and follow-up arrangements before you decide. You do not need to choose a dose or work out the target muscle before booking.

Your questions

Ultrasound-guided Botox FAQs

What the extra imaging can add, and what stays the same.

Is ultrasound-guided Botox better than ordinary Botox?
It can add useful information when a muscle needs closer assessment or more specific targeting. Routine Botox can be planned effectively through examination and knowledge of anatomy. Dr Alex will recommend guidance when it has a useful role in your treatment, rather than assuming everyone needs a scan.
Which muscles can you look at with ultrasound?
The masseter at the side of the jaw is a useful example: its thickness, boundaries and movement can be assessed on screen. Other muscles may be assessed depending on the concern. The areas appropriate for your treatment will be discussed at consultation.
Can it help with a bulge after masseter Botox?
Yes, a scan can help assess a bulge that appears when you clench and show whether part of the muscle is still contracting. That may help plan a targeted correction. Dr Alex will first check what is causing it and how recently you were treated; an extra injection isn't always the answer.
Can it help if Botox hasn't worked for me before?
It may help if the issue relates to the target muscle or placement. Other explanations include dose, timing and the concern being something Botox cannot change. A scan cannot tell whether you have resistance to the medicine. Bring any previous treatment information so Dr Alex can assess the whole picture.
Will the scan make the result last longer?
Ultrasound is not a way of making the medicine last longer. It helps with assessment and targeting. Duration depends on the treatment, muscle and your individual response; the scan alone doesn't establish a different maintenance schedule.
Does ultrasound stop Botox spreading to other muscles?
It helps Dr Alex identify the target and nearby structures, but it cannot guarantee that neighbouring muscles will be unaffected. Dose and placement still matter, and the usual treatment risks still apply.
Can ultrasound-guided Botox help teeth grinding?
Botulinum toxin may be considered to reduce the force of an overactive chewing muscle, and ultrasound can help assess and target it. Grinding and jaw pain can have several causes, so treatment may also involve your dentist. Reducing muscle activity does not repair worn teeth or replace dental assessment.
Does the scan hurt or add recovery time?
The scan is usually comfortable: you'll feel gel and the probe moving on your skin. It doesn't add an injection or a healing period. Any tenderness or bruising comes mainly from the injections themselves.
Is this the same ultrasound used for HIFU?
No. This is imaging ultrasound, used to see beneath the skin and guide an injection. HIFU is a separate treatment that delivers focused ultrasound energy into tissue. Having an ultrasound-guided injection does not also give you a skin-tightening treatment.
Should I book this instead of my usual Botox appointment?
If you're happy with your usual treatment, you may not need to change it. If you have an uneven response, a muscle bulge or a question about targeting, mention that when booking. Dr Alex can advise whether an ultrasound assessment would be useful.

Related treatments

Explore the treatment area in more detail

Masseter Botox and teeth-grinding treatment explain the jaw-related options. If your main concern is forehead lines or another facial area, its treatment page can help you understand the result to expect.

Masseter Botox in Hale, Altrincham

Slim an enlarged jaw muscle or explore treatment for heavy clenching. Masseter Botox with Dr Alex at SONÜ, with assessment of your facial shape and jaw function.

SONÜ, Hale, Altrincham

Find out whether a scan would help

Bring the area you'd like Dr Alex to look at, along with any details of previous injections. He'll explain what treatment could change and whether an ultrasound scan would help plan it.

Book a consultation Contact the clinic
SONÜ Medical Aesthetics

34 Hale Road, Hale, Altrincham, WA14 2EX

Doctor-led treatment in a relaxed, private clinic

Close to Hale station and easy to reach from Altrincham, Manchester and Cheshire